生态系统视角下滞留患者的社会工作介入——基于上海市D院社工部临床个案记录分析

Social Work Intervention of Stranded Patients from the Ecosystem Perspective:Based on the Clinical Case Record Analysis of Social Work Department in Shanghai D Hospital

以D院滞留患者服务为例,探索滞留患者的多重需求,构建生态系统视角下社会工作介入滞留患者的干预模式。采用个案研究的方法,以D院滞留患者服务为例,对49份个案记录和利益相关方的访谈逐稿进行主题分析。滞留患者出院安置面临个人、家庭、医疗及社会系统的多重障碍。研究构建了生态系统视角下社会工作介入滞留患者的干预模式:信息收集与需求评估、赋权个人支持系统、重建家庭支持系统、协调医疗支持系统及链接社会支持系统。介入过程取得良好成效,滞留患者的社会工作介入应关注患者的心理社会需求,提升系统困境的觉察;动员多系统支持网络,结合个案管理方法递送服务;进行社会倡导,寻求法律与政策的突破口。

Based on the service of stranded patients in D Hospital,this study aimed to explore the multiple needs of stranded patients and construct an intervention mode from the ecosystem perspective.Using the method of case study,taking the service of stranded patients in hospital D as an example,49 case records and verbatim interviews with stakeholders were analyzed.The discharge and resettlement of stranded patients faces multiple obstacles from individuals,families,medical and social systems.This study constructed the social work intervention model from the ecosystem perspective:information collection and needs assessment,empowerment of individual system,reconstruction of family support system,coordination of medical system and linking social support system.The intervention process achieved efficient effects.Social work intervention of stranded patients should pay attention to patients'psychosocial needs and improve awareness of system difficulties;mobilize the multi-system support network and deliver services in combination with case management method;conduct social advocacy for the breakthrough of law and policy.